A non-invasive method to detect cardiac fibrosis – detecting early changes before progression to heart failure

Experienced radiographer Xin Dong is developing a non-invasive method to detect early signs of cardiac fibrosis, before progression to heart failure

Many types of cardiac diseases and conditions are associated with abnormal thickening and scarring of heart tissue, known as cardiac fibrosis. Linked with reduced cardiac function, cardiac fibrosis is associated with progression to heart failure and poor prognosis. 

If detected early, some types of cardiac fibrosis can be potentially reversed under specific management. However once it has progressed to advanced stages, these changes are irreversible, and with limited options for treatment, management is focussed on managing symptoms and prolonging life. 

Currently, methods to detect cardiac fibrosis are limited to either invasive cardiac biopsy or MRI with contrast, which can only detect cardiac fibrosis at advanced stages. However, if cardiac fibrosis can be detected non-invasively at an earlier stage when it may still be reversible, this may provide a window of opportunity for patients to implement lifestyle changes, with or without medication, to prevent progression to heart failure. 

Experienced radiographer, Xin Dong, is embarking on a PhD project to detect early signs of cardiac fibrosis using a previously described technique called ‘T1 mapping’, based on magnetic resonance technology. This technique can be used to see molecular changes to cardiac tissue after it has been exposed to a magnetic field. While the molecular ‘relaxation times’ of healthy myocardium are relatively uniform, changes to these parameters can indicate the presence of disease. 

Previously used by other groups in hypertension and cardiomyopathy, Xin aims to validate T1 mapping to detect changes to cardiac tissue in patients with obesity-related cardiomyopathy, amyloidosis and radiation-induced toxicity from cancer treatment. Using a longitudinal approach, Xin will assess the T1 mapping results of patients before treatment for their condition, and at six months post-treatment to determine whether T1 mapping can be used to differentiate between patients with active disease and those who have been successfully treated. 

Progress to date

Since commencing this PhD project in late 2017, Xin has obtained pre-treatment measurements of twelve patients with obesity and type 2 diabetes, and three with amyloidosis. The work so far provides a solid foundation to progress towards assessing more patients with these conditions and determining what differences can be seen post-treatment. 

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Project supervisors: Xin’s project is supervised by Professor Graham Galloway, Director of Imaging Technology at TRI, Associate Professor Arnold Ng, a cardiologist at the Princess Alexandra Hospital, and Associate Professor Robert Robergs at Queensland University of technology (QUT).

Collaborators: The project involves a collaboration with clinicians at the Princess Alexandra Hospital, particularly in the Cardiology, Endocrinology, Radiation Oncology, Haematology departments and Amyloidosis Centre. 

Picture: Xin Dong at the Siemens 3Tesla Prisma MRI.